Alcoholic liver disease laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Laboratory tests

Hemogram

• Macrocytic Anemia
• Thrombocytopenia (causes are toxic effect of alcohol on platelet and splenomegaly)
• Leukocytosis

Liver function tests

Diagnosis typically relies on laboratory tests of three liver enzymes: gamma–glutamyltransferase (GGT), aspartate aminotransferase (AST), and alanine aminotransferase (ALT). Liver disease is the most likely diagnosis if the AST level is more than twice that of ALT , a ratio some studies have found in more than 80 percent of alcoholic liver disease patients. An elevated level of the liver enzyme GGT is another gauge of heavy alcohol use and liver injury. Of the three enzymes, GGT is the best indicator of excessive alcohol consumption, but GGT is present in many organs and is increased by other drugs as well, so high GGT levels do not necessarily mean the patient is abusing alcohol.

• Raised serum bilirubin
• Elevated liver enzyme
  • AST usually elevated more than ALT (commonly by factor of 2 or more)
  • AST usually elevated but not more than 300 u/L
  • Elevated alkaline phosphatase (infrequently more than 3 times of normal)
• Prolonged prothrombin time (> 6 seconds above control)
• Serum protein
  • Decreased serum albumin
  • Increased gamma globulin
• Iron studies
  • Increased transferrin saturation, hepatic iron stores, and sideroblastic anemia
• Folic acid deficiency